Date   

Re: Length of laminitis

Eleanor Kellon, VMD
 

Rose,

I start the J at the same time the  taper is started.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: HA Dosage

Eleanor Kellon, VMD
 

Caroline,

 It's probably safe but, as usual, untested. HA is most helpful for acute problems. If this is chronic, look into adding Devil's Claw.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Insulin Testing

Eleanor Kellon, VMD
 

Maria,

Yes on the tube types. Both should  be spun/separated  before sending and ACTH should be frozen.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Equioxx

Eleanor Kellon, VMD
 

Kelly,

Do you know the nature of her current lameness? Manica flexoria surgery usually entails removal so it wouldn't be that again.   Is her ACTH controlled?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


HA Dosage

Caroline
 

Is there a recommended HA dosage for horses?  Evan has ben on 300mg for a while and it's helping but we had an issue yesterday that highlighted that he probably needs more support.  I started at that level because it was the highest dose included in general joint supplements, but it's only twice the human dose on the bottle.  Does anyone know if it's likely to be safe to increase the dosage  further?

Thanks

And apologies I need to update my CH
--
Caroline
Spalding, Lincolnshire, UK
September 2019
https://ecir.groups.io/g/CaseHistory/files/Caroline%20and%20Evan
https://ecir.groups.io/g/CaseHistory/album?id=231916


Re: Updated Case History, please help

Eleanor Kellon, VMD
 

 Just to clarify, the liquid available here is in water, not oil.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Equioxx

Eleanor Kellon, VMD
 

In addition to the side effects which all NSAIDs have (and are the reason why they are not supposed to be used long term), NSAID use worsens vascular problems. Read this file: https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/Why%20NSAIDs%20&%20Icing%20Are%20Not%20Recommended%20.pdf .

The GI and circulatory toxicity is due to interference with nitric oxide production. In fact, the newest drugs in this class are combinations of NSAIDs with nitric oxide https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582807/. Enhancing nitric oxide is what makes Jiaogulan so effective but it can't work when the NSAID is on board.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Relevante Trim

Lavinia Fiscaletti
 

Hi  Lynn,

I've added the latest mark-ups to Relevante's album:

https://ecir.groups.io/g/CaseHistory/album?id=36909&p=Created,,,50,2,0,0

The good news is that he continues to develop more concavity, some of the extra bar material is starting to detach on its own and the heels have started to move back under him more. In general, you want to continue working to move his heels back without dropping them; beveling the toes well to get and maintain the breakover n the correct location; keep the ragged tags on the frogs cleaned up. Watch that the wall height beyond the sole plane doesn't creep up beyond 1/16'', esp. in those areas where the walls still aren't well connected due to flares growing out.

RH lateral: Mustang roll the toe area hard in the blue area.

RH dorsal sole plane: Blue are at the toe is where to roll it well. Blue Xs are all the tags of loose frog material that can be cleaned up but don't get overzealous and trim the entire frog just to make it look "pretty".

RH sole: Solid blue line shows where the perimeter of the hoof should be. Hashed areas are all somewhat detached wall that needs to be rasped away from the top, then beveled/rolled under. Orange circles are the areas that should be the highest point on the heels and shouldn't be lowered. They are where the bar-wall junction should end up.

LH: Roll the toe well ala Mustang Roll in the blue area.

LH dorsal sole plane: Solid blue area corresponds to the blue on the lateral view. Blue Xs on the lateral bar are where it is already lifting away, so just help it along. Blue on the back of the frog is the ragged frog that also be trimmed away.

LH sole: Similar to the RH. Blue solid line denotes where the hoof perimeter should be, hashed area again needs to be brought inward to remove the already weakened wall and take it out of weight bearing until it has grown out well-connected. Blue Xs are where the bars are already detaching, so just clean them up in those areas - but not all the way back to bar-wall junction. Orange areas are again where the bar-wall junction should end up and they should be the highest point. Nothing off those areas.

RF dorsal: Blue line shows where there is still a slight lateral wall flare that can be rasped down and beveled under.

RF lateral: Mustang roll the toe well. 

RF dorsal sole plane: Same idea as the hinds.

RF sole: Same discussion as the RH.

LF lateral: Solid roll on the toe in the blue area.

LF dorsal sole plane: Same as RF.

LF sole: Same ideas as the the other three.

Check the collateral groove depth on both sides in each foot to make sure your are maintaining medio-lateral balance. Be careful not to lose vertical height in the heels/back half of the feet relative to the vertical height in the front half so that you don't inadvertently lose any of the gains that you've made in realigning his HPAs.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR


Re: Length of laminitis

Rose Miller <Rosemiller@...>
 


-- I also want to taper off Equioxx, how do you add the J Herb as I do that?
Rose Miller in Arizona 2020


Re: Questions concerning recent PPID diagnosis

anneefrancis@...
 

Hi Sherry,

I found the ration guide that I have been following for Tricana's feed and uploaded it in my case file folder.  I had a few things wrong like her weight (though this was a few years back so will revise)  for example and the amount of Enhancer we've been feeding.  Also, as I mentioned, I've taken to free feeding her hay.  It takes her 3 days to get through a small bale, which probably weighs 60 ish lbs so she's not gorging but I will weigh out a specific amount for her moving forward.  We've also been using Cocosoya to mix in her sups or she won't touch them - I suspect it's too much calorically.  We are testing this year's hay this week and I will upload the results when I get them.  

Warmly,


Anne and Tricana
May 2016
https://ecir.groups.io/g/CaseHistory/files/Anne%20and%20Tricana


Re: Willow test results, x-rays and exercise recommendation

Pat
 

Ah! I think I had read under guidelines on exercise somewhere that anything under 30 mins with no sweat didn't count. I was probably misinterpreting it - I get now that it doesn't count as exercise from a fitness perspective but might still damage her feet from a soundness perspective.

So many people I run into are so paranoid about not riding horses! At my last barn, two people thought I should ride her when she was right in the middle of the laminitic episode. I was shocked. 

Right now she is playing with the baby welsh colt in the paddock next door, running in and out of her stall as he runs in and out of his.  At least, the barn owners tell me it is playing, although some fence keeps getting broken! I hope we don't get asked to leave because it is a very good place.


--
Pat
August 2020
Metro Vancouver BC Canada
Case: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Willow
Photos: https://ecir.groups.io/g/CaseHistory/album?id=253325


Re: Willow test results, x-rays and exercise recommendation

Lorna Cane
 

Hi Pat,

I'll be interested in what Lavinia has to say, and am totally happy to be corrected , but my interpretation of the exercise you are planning to continue with falls into the 'formal' category,which Lavinia mentions.
If she were mine, until her trim has been addressed, I'd  let her move around as she sees fit, and definitely not ride her. (I'd bet big money she won't forget 😊)

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Re: Equioxx

Brenda Gasch Mittelstadt
 

Sorry - I see someone did answer. I forgot to open all messages! 
--
-Brenda

September 2020, Dodgeville WI USA

Case History: https://ecir.groups.io/g/CaseHistory/files/Brenda%20and%20Stormy


Re: Equioxx

Brenda Gasch Mittelstadt
 

Hello Kelly,

I am not going to answer your question as I do not know the answer. I have a mare that's been on Equioxx for a half year or so for some unknown back issues that cause her spasms and then a light laminitis in March and possibly arthritis. I just am interested to hear you say that the group does not recommend NSAIDS and, as a newer participant, I did not know that. Can you expand on the reason and also what you think the risk is? I've been told the Equioxx (by my vet) is super safe. I also see a much happier mare like your Micah. Mine is Daisy. 

I did hear about STP with the yucca and a couple other things and am considering that. 

Sorry to not answer but really am interested in the reply so wanted to add my voice. I'll be interested in other's ideas. 

THANK YOU!
--
-Brenda

September 2020, Dodgeville WI USA

Case History: https://ecir.groups.io/g/CaseHistory/files/Brenda%20and%20Stormy


Re: Insulin Testing

Sherry Morse
 

Hi Kelli,

I would suggest contacting Chaffe hay's manufacturer directly and ask them for the guaranteed analysis including ESC and starch numbers so you know if it's safe to feed to your guy.

As far as the mini-melt tabs.  They are not necessarily the best form of pergolide.  We've had a few members use them with varying levels of success.  Most members prefer to use the capsules which can either be dissolved in water and syringed or put into a treat and fed directly to the horse.  If you're counting on putting the medication into grain and it being eaten there is always a chance that not all of it is going into the horse.





Re: Willow test results, x-rays and exercise recommendation

Pat
 

I've got her on tested hay, with amino trace + and j-herb, flax, salt.
Regardless of her tests, I intend to keep her on this diet and no grazing. Forever.  (-:
--
Pat
August 2020
Metro Vancouver BC Canada
Case: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Willow
Photos: https://ecir.groups.io/g/CaseHistory/album?id=253325


Re: Willow test results, x-rays and exercise recommendation

Pat
 

Thanks! Good to know.  I don't mind not doing a lot of exercise but other people sure worry about it.  I think I will have 10 mins of hand walking, ten mins of riding (just so she doesn't forget) and no trotting.  At least until after Christmas.

There was a trim done just after the x-rays were taken. Another scheduled soon.

When I click on my case history link in my signature, I see three case histories, the first one (no date), one dated Oct 14 and the one dated Oct 26. Can you see any of them or just not the Oct 26th one?

Her test results were:
Glucose 7.13
Insulin 14.4

Calculator says:
Gi 7.13
Risqi 0.26
Mirg 5.8

--
Pat
August 2020
Metro Vancouver BC Canada
Case: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Willow
Photos: https://ecir.groups.io/g/CaseHistory/album?id=253325


Re: Insulin Testing

Kelli Land
 

Thank you Dr. Kellon.  We will be doing the cornel metabolic panel on him this week.... he is eating better this week now ,,,, and more life to him. I think he maybe have been depressed with his pasture pal passing as well. He has another horse to hang with but this is a youngster and a bit of kid still. I live in an area that it is hard to get appropriate feed. Small community feed stores won't carry more then what they feel will sell.... even with a commitment. I had totally dropped his feed to pellets only ,, no forage due to his dental health and recommendations of our equine dentist. He right now is happy with getting a bit of forage and no Bermuda pellets,, plus  increased his LMF SR low carb....since that is a complete feed. I also added brewers yeast recently as well.  

Finding Teff around my area is near impossible,, however there are some places south of me or north of me to buy if I don't want to travel 2-4 hours to go get it. Feed stores just wont bring it in. Timothy is also hard to find,,, and again I can travel a bit to get it. These are not favorite options since quantity only makes it affordable and reasonable, and I don't have enough storage to put up 80 bales of hay right now, only a few at a time.
I know Teff pellets are made up in Oregon, but again I cant convince any feed store in Cali to even carry the stuff. argg frustrating for sure.

I have been soaking the orchard alfalfa,,,, until we work thru this problem. My memory from last year this time of year after I increased his pergolide to the fall winter dose he did this as well but not as bad and not loosing weight. It seemed to happen very quickly. Such my concern.  I am working on the case paper ,,,, to get uploaded to the site as we speak. It made me feel a bit better when he was eating better over the weekend,,, and he was not dogging about. We actually did a trail ride locally and he was in the lead single footing down the trail with bouncy ears with his gaiting friends in tow.

One product I can get locally is Chaffe hay. The feed store that will carry my LMF feed was sharing info on the product and my needs as I was pushing again for the teff pellets/hay/timothy pellets/cubes. Chaffe promotes the benefits well, but their analysis is hard to put into perspective to what other feeds have to offer. It seems palatable as I tried a sample and he did eat after walking away from it initially. I am reading about it... but I did not see it as one of the approved feeds on the list from the website.

I am also researching the compounded formulas. I get it why prascend is recommended over compounded pergolide. In asking about the compounded formulas,,, I like the mini melt tabs. That has been the hardest part of treating this horse... as we all know hates the taste so I mix it with a bit of pellets before he gets his feed so I see he gets it. however when he wasn't feeling so good I was out of town and the other horse went down so Who know if the was getting it correctly with the house sitter I would hope so.... but...
I found the cost more reasonable with the compounded formula so going to work thru what I have and move to the compounded formula. Crap 3 times amount of medicine for the same cost  no brainer..... I always thought doing the compounded way was not the best but that was early days when it was only liquid and it was harder to manage the liquid formula and shelf stability was short lived. So very excited. In the mean time I am going to try taking  the pills a i have and grind them up to put in a capsule and see if that works better in getting it in his body. 

So again thank you for your direction and ideas ,,, and a great website... I was on it when we started this journey 5 years ago. but had put it away ,,,, maybe a older and wiser has made it stick more in my brain..... It certainly is helping me now.

of course i will keep chugging on his case file,,, and get it uploaded when done... it was a bit daunting when I started it,,, but working thru it... 

thank you 

Kelli Land, RVT

On Monday, October 26, 2020, 08:29:11 AM PDT, Eleanor Kellon, VMD <drkellon@...> wrote:


This study found that insulin testing of samples taken into an EDTA plasma tube (purple top) showed significantly lower levels than serum (red top) or heparin (green top) samples. Best stability when testing is going to be delayed beyond 3 days is heparinized samples.

https://pubmed.ncbi.nlm.nih.gov/31617618/

If you are using Cornell's ACTH/insulin/leptin panel the sample will be EDTA unless the vet also draws a separate serum sample and requests that be used for insulin.

Bottom Line: Use serum or heparin tubes for insulin testing. Varying sample type between tests will not give you accurate results.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--

--

Kelli L. in CA 2020


Re: Willow test results, x-rays and exercise recommendation

Lavinia Fiscaletti
 

Hi Pat,

Thanks for adding the rads.

There is no bony column rotation but there is a slight bit of capsular rotation - which is a trim issue due to her much-too-long toes. Heels are underrun as well. There appears to be some sinking, which goes along with the thin soles. Some arthritic changes on P2 as well.

Until the trim gets optimized, I wouldn't recommend formal exercise as it is going to exacerbate the pull on the laminar connections from the long toes, causing more damage.

Definitely should keep her in padded boots until the sole depth increases, which won't happen until the toes are shortened.

Sorry, but I don't see a 10-26 case history for her in your file.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR


Re: Updated Case History, please help

Loreto Hosking
 

Re pergolide compounded in oil:

I changed from Prascend to compounded pergolide in oil several years ago, when my two PPID thoroughbreds hit doses required in the teens.

This formulation kept them in the reference range for years, with appropriate testing and dose adjustment. As a vet I am fortunate to be able to manage all of this myself.

My current crop of 3 PPID horses have also been on the oil preparation for years, keeping their ACTH in the mid- high-teens. They are routinely tested twice a year and the dose adjusted. Currently they are on between 4 and 8 mg of pergolide mesylate.

It’s easy to adjust and simple to administer, and at least in my case, appears to have very good stability.

Loreto Hosking


--
Loreto Hosking
Emerald, Vic, Australia
Flecky, Cruiser, Charlie and Pretzel (dec)
Poppy, Merlin and Toby
January 2016 approximately 

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